america exhibit. it's available to go see. you can also look at online at loc.gov your but we would like your input. what books do you think should be included in such an exhibit and what books shouldn't be included? if you like to participate in online discussion with roberta shaffer, associate librarian at the library of congress, one that we will then air on booktv, we would like to hear from you. e-mail us at booktv@c-span.org. ..

>> peter piot who has been on the front lines against aids talks about his career. he's the executive director of the joint united nations program on hiv/aids and author of "no time to lose: a life in pursuit of deadly viruses." he was interviewed at an event in new york city. this is an hour. >> so, peter, you were a whopping 27 years old -- [laughter] you had finished medical school, but you were just getting started in your ph.d. efforts in microbiology at the institute of tropical medicine in antwerp.

a mysterious test tube sample shows up in terrible condition, and you figure out that there's some new disease in africa, and you have the chutzpah to say i know i'm only 27, but i want to go there. let me go, i want to be in the middle of this adventure. where did all this gall come from? >> i'm actually a pretty timid and shy person. >> oh, yeah, right. [laughter] >> coming from flanders where my mother always said speaking is silver, silence is golden, son. anyway, i think i'm a bit different. no, first of all, i had an incredible urge for discovery from when i was a child, and when i was a teenager, i worked for a travel agency and went one month to morocco, one month to turkey at a time when there was

basically no touristic infrastructure. and when i was 10, i had one goal in life, and it was get out of here, get out of my village which was kind of a very conservative flemish village. but it was a combination of this sense for adventure but also the incredible curiosity for things which was to the despair of my mother and my whole family because when i was like in this, i always asked why which drove everybody nuts, you know? that was the kind of kid i was. and not to annoy people, but i really wanted to know. and i also had not much respect for hierarchy and authority. so, yeah, tsa why i said, yeah, let's -- that's why i said, yeah, let's go for it and let's do it. not because i'm 27. also later on most people who had more seniority and more experience, they actually were

not so jumping up and down to fly to zaire and to -- >> because they knew what a hell hole it would be. [laughter] and you didn't. >> yes. yes, i guess so. >> but coming away from the way you describe the episode, there's four things that i think are the key experiences or realizations, the aha moments for you out of the ebola 1976 episode. because this strange test tube and this 27-year-old flying to africa for the first time is, as it turns out, the ebola epidemic. first, you experience africa, and you fall in love with africa. >> right. >> secondly, you discover internationalism and all the difficulties of coordinating and working together with scientists and all sorts of other folks from around the world. you discover the relationship between global inequity and

disease, that if people are so poor, they don't have sterile syringes. and then you discover do-gooders can do so badly, it would be better they weren't there in the first place. >> yes. you read the book. [laughter] >> let's take these apart. why, what was it that this young flemish 27-year-old fell in love with? >> well, i think it was the warmth of people, you know, the human side, the creativity. i cannot hide, also, the music and the dancing. [laughter] but the fact that, um, i thought it was on the one hand, um, so much to do, incredible needs which are still there, and, um, the will to improve it. and so i saw opportunities which

i think are very underestimated today in africa. when b you look at -- when you look at just growth of the world, i there in africa. i'm not saying that africa now has made it. we see natural resources that are there. so, i mean, i think that it's -- i didn't know all these things in these days, but it was a combination of the gut feeling and the warmth of people, you know, the human side, but also the sense -- i got also very upset and angry because of the inequalities of the, you know, zaire was then ruled by mbutu, and there were a group of plutocrats stealing the country to death literally. and on the other hand, you know, young people there was a great university in the old days, you know? but nobody was paid, there was even no electricity and so and so. people were denied some basic,

um, opportunities. but it's -- i can't explain it why. i was bitten by the virus for africa -- >> there's a lot of dancing in the book if you haven't read it. [laughter] there are many times when peter is so ecstatic, he breaks out dancing all over the place. >> yeah. >> now, this also was your first experience trying to work with american scientists -- >> yes. >> and the americans came in and said they're in charge. particularly carl johnson from the cdc. >> yeah. >> and you found african colleagues to collaborate with and fellow belgians, particularly some who came a little bit later after you'd been there a while. tell me about what you learned in '76 that guided you forward about international cooperation. >> yeah. one, i discovered that where i came from the media had both financially and technically were far inferior to what was available here in the u.s.

and whereas i recemented that, we had ice -- resented that. we had isolated the virus for the first time, and the folks from cdc came and said we're taking over, and so i resented that. that's absolutely true. and then i saw i could learn so much. and someone like joe bremmen who elucidated me in epidemiology, and i'm really still grateful for him. it was not only the u.s., but there were -- it's like in some of these jokes. i mean, there was a frenchman and a south african and a brit and a belgian and an american and then some congolese in a plane, and what happened? what do you do? the power of coming up from different perspectives, i found fantastic. but i was very impressed by the superiority, the technical superiority and the strategic superiority of our american colleagues. so while i was there i said, you know, i want to go to america

and learn and just to see that. next time we find a new virus, you know, i can be in charge also. it was not only for myself, but just to be, you know, to share this. rather than to stay in america, i came back to belgium and, okay, here we went. >> the sad thing you discovered after seeing patients bleed out, the horrors that are ebola, if you haven't seen it, a very terrible disease, and it's an awful way for anyone to suffer before dying. but particularly sad thing for you is a flemish kid who'd grown up in a belgium at a time when french speakers or were the dominant, you know, power structure of belgium, and the flemish were all held down. and you get out into this very, very remote village in zaire and discover the responsibility for it all really rested with fellow

flemish catholic missionaries. >> right. >> tell us what that meant to you. what did you discover? >> well, on the one hand i was full of admiration for these women particularly, because the sisters they were dealing with, you know, they had the school and the hospital. the fathers were more into prosthelytizing activities. and they were hard working, dedicated, but they were running a hospital, and there was not one person who had a formal training in nursing or in medicine and 110 beds. and so one of the things i learned is that it's not puff wanting -- not enough wanting to do good, you also need basic competencies. you know, you need expertise. otherwise everybody who comes to this hospital and to the outpatient department when you only have three or four syringes and a few more needles. so that was one thing.

on the other hand, i also discovered that it was like the time had stood still. so these were flemish nuns who had left belgium years before, and they were still thinking of the motherland as if time had stood still in belgium also which you find often with expatriots. and they have an idea of them, the country of origin doesn't correspond anymore with how it evolves. and so that was also -- it remind me of my grandmother, my, you know, my ancestors. that was something i hadn't expected. like winter on the equator where it's very hot, that's not very adaptive to -- >> but you each today are still in touch with one of the priests, yeah? and he's still there? >> yes, father carlos on the

congo river. where the river is about 20 kilometers wide, it's just incredible. and he's there, but now in contact with him by e-mail. and when i talk about this, the students stare at me as if i'm coming from the stone age that there was not even cell phones that didn't exist, satellite phones didn't exist, no internet, no facebook, no etc., etc. so communication didn't exist. but you he's really, has started a secondary school. there is, um, you know, the hospital in so and so. you know, in the superior in congo -- in the interior in the congo, outside the missions is often nothing else, so that's the reality. >> i mean, to flash forward a little bit, the last time anybody took a count that i saw in the post-2000 era, 60,000

ngos related to aids in africa alone have been created. and when you think back to those missionaries who thought they were doing the right thing but, goodness, if you don't know how to use syringes properly and basic sterile hygiene, perhaps it would be better you weren't there in the first place. what lesson do you see looking forward to this explosion of ngos that can be informed by that experience? >> well, the good news is that in a global health, the term of which didn't even exist until about 12, 13 years ago. i tried to figure out when did it appear for the first time, but global health was created by the aids movement in a sense. so the incredible interest and money, that's the great news. but on the downside often it's not always going with the most professional approach.

so the key is to combine the enthusiasm, the dedication, um, the commitment with, um, know how and with strong evidence-based practices. and that's not always there. that's one of the reasons i was so interested to move to the school of tropical medicine. even if i had said never again in academia after i had left it. just like i said never again in the u.n. now here i am because we want to train the next generation of leaders in global health, and that's the best institution to do that. >> in 1979 you participated in an autopsy on a belgian sailor, and you say in the book: i wasn't smart enough to see that it was a new syndrome, but i knew we'd never seen anything like it before, and it was -- >> aids as we know today. >> what was so striking about it that you knew just looking at

this body before you that this was a new disease? >> yeah. it was someone who was a fisherman at one of the big lakes in congo, and the person died with what's called disseminated atypical microbacterial infection. what is this? microbacteria in tuberculosis causes tb, but there are also in the environment ubiquitous microbacteria which don't really create any problem. probably most of us hire are covered with it -- here are covered with it. but when you're a fisherman, it can kill you. and we had never seen that. you just, well, cut in the muscle and so on, and there were these microbacteria. you can see them under the microscope. very strange. and we started seeing then some others with other, um, weird infections. it's the same way that aids was

described for the first time in this country but then with other opportunistic infections. >> you decide that sexually-transmitted diseases are acutely important, and it's so importanting that -- so besting that you -- interesting that you adopt that as one of your interests when almost anybody else would be, ooh -- >> yeah. >> there's all this cultural -- you come to the united states, you had a whole bunch of training in that area, particularly from king holmes who's still in seat and still a real leader in stds. and then you go back to in 1983 to africa with some of the same people that you were in the ebola epidemic with. you're in that massive, i mean, anybody that's ever been in

africa knows what i'm talking about, massive colonial hospital. and you say in the book -- you wrote in your diary: incredible, a catastrophe for africa. this is what i want to work on. it will change everything. what was so incredible? what would change everything? what were you looking at in that hospital? >> the hospital, by the way, is the name of mbutu's mother. dictators seem to really love their mother, and they have something, and they name all kinds of things after their mother. [laughter] no, i had been there in '36, gone through -- '76, gone think the files, and here -- gone through the files. and suddenly they were full with young men and women, in these todays of my age, and dying. emaciated and all kinds of infections, just name it. and we had, like, 100 cases and

patients coming from central africa and belgium that's why i went there with tom quinn and joe mccormack. and it was so overwhelming because i knew that was not there before. and also the head of the internal medicine there had, you know, put aside for us, like, 50 files of patients who had died already in the previous month or so. and this was the ec tent of it -- extent of it, the fact that it was like slightly more women than men which was very unusual. let's not forget in '83 what was the dogma? this is a gay thing. and i never understood why a virus would care about the sexual orientation of its host, you know? because for a virus what is it? the purpose of a virus is to perpetuate its life, so jump from one host to the another. that's what sex is about. so i saw that, and i said

whereabout this must be -- you know, it's heterosexual, that's one thing i said, and there's far more heterosexual sex in the world than same-sex sex, and knowing also from my studies on sexually- transed diseases -- transmitted diseases, i said this is going to be a catastrophe. and unfortunately, i was right. >> well, then you together with jonathan mann, an american, set up aids project in africa, and the first time we met was 1985. it was the first international aids conference in atlanta, georgia. >> right. >> which fit almost -- >> in one ballroom. >> yeah. hard to believe because the upcoming aids meeting is going to have about 25,000 people. and, first of all, i don't think we could possibly have imagined -- i know i couldn't -- in 1985 at that meeting that we were at the front end of something that would still be around in 2012, that would by

then have sickened or killed about 74, 75 million human beings, that in 2012 there'd be 34, 35 million people alive with this disease on every continent on earth. we couldn't have imagined it. >> no. >> but what i remember most disat this pointly about that meeting was there was a moment when this very tall white guy was translating for a much shorter fellow, and a cluster of us were standing around you. and a "wall street journal" reporter who was absolutely sure that hiv was a gay disease wouldn't accept the notion of general heterosexual transmission said to mr. capita, isn't it true that africans have sex with monkeys? and i remember this guy trembling with rage, your face changed colors. be and yet you knew you had to

translate. what was capita's response? >> yeah. i was this tall white guy. [laughter] well, capita thought -- first he pretended that he doesn't understand english, so that gave him time to speak. and then he said, well, he said, we don't -- something i'm not aware, we don't do this or something like that. he was very calm. but i heard about things here with dogs, you know? [laughter] and don't people go to tijuana to see donkeys? [laughter] but if you think about it, and i do want to bring michelle in in a moment here. but to flash forward and frame that period because your title is "no time to lose." all through the book you express a sense of urgency to respond and regret that the response wasn't faster. and if you look back to that

critical period in the 1980s and '90s before we had effective treatment in 1996, we had many moments when interventions were blocked because of the human rights issues. so that we never could tackle hiv the way we did syphilis or gonorrhea. and the rationale for not doing so was, well, there's treatment for syphilis and gonorrhea, but there's no treatment for hiv, so they will simply lead a life of discrimination. when you look back, do you think there are tools of public health that we failed to embrace powerfully enough putting aside the blame to international political leaders, but within the public health arena? are there things when you look back you feel we should have done this, that or the other thing before we had medicine?

>> well, we definitely lost a lot of time, we wasted a lot of time by not recognizing it in every country. when you think how president reagan or prime minister thatcher could simply not even pronounce the word aids until the very end which is, i mean, i'm not a psychiatrist, but in psychoanalysis that means something. so the fact that the lack of willingness to deal with the issue, also in public health circles. first, dealing with aids because it was, you know, first it was in the category of sexually-transmitted diseases and all that which is not on the top -- yes, exactly. we stay away from this. we are not like that. but then, also, later on when it came to treatment l -- and i know we're going to talk about that later -- but it was the public health community which was the biggest problem in the sense today had all these -- they had all these reasons why

it's not possible. i think there were also some absurd activist demands, it's true. i was shocked in atlanta there was the whole campaign, no test is best. i remember that -- which i didn't fully understand. on the one hand, it's true because of the discrimination and stigma that all we could offer was kind of negative. death sentence, because there was no treatment, and then discrimination, you would lose your job, your insurance and so on. but i think retrospectively, indeed, we should have had a far more adult conversation about what can be done. but you can't see public health in isolation from what's going on in society. >> but we had a case example of tremendous victory, and it didn't catch on, it didn't go viral so to speak as we would see today. and that was thailand. if you look at the late 1980s, the asia development bank had predicted thailand was going to collapse under the pressure of aids. the 17-year-old recruits into

the military were running as high as 3% hiv positive at the age of 17. >> yeah. >> and by the time they were 22 in the military, the rate was way beyond that. and it looks catastrophic. and they had no tools except condoms. >> yep. >> and they brought it completely under control. >> oh, no, no, that's true. >> why didn't that become the model for the world? why was everybody -- why did we all look at thailand as if it was that isolated case? >> no, i think that's a good example of why did it work in thailand, because of strong leadership and not worrying too much about public opinion and said 100% condom promotion. the enforced in a way -- it was enforced in a way, you know, with not only public health people, but they went to see their brothers and so on. it was to preserve -- [inaudible] sex in the street which is worth millions of dollars, but it was

something there was willingness to do. even today do you see an ad for condoms in this country? >> on mtv you do. >> oh, you do? okay, good. [laughter] but it is this double standard about sexuality and sex, and, yeah, not wanting to deal with the issue. >> even today the thailand example does not resonate. >> yeah, but thailand there's problems. they're not dealing with gay men, they're not dealing with injecting drug users for years, and they don't want to go for methadone. but they were very, very effective, particularly when mechi was the prime minister. that's the ultimate success in branding, when your name becomes the thing, you know? [laughter] >> well, i can't, um, move on without giving you opportunity to hit two of your most

remarkable encounters. first, an office -- i think i remember right -- was mahogany lined, everything about it seemed like you'd gone to oxford. there's a gentleman sipping expensive scotch and smoking a pipe -- >> okay. >> and he's telling you great paranoid conspiracy theories, and you cannot wake him up. who is that gentleman, and what did he cost african lives? >> this is president mbeke. there was also fireplace, complete picture. and, yeah. after a very late night encounter and conversation, he told me, peter, don't you know this is a conspiracy of the western pharmaceutical companies to poison us africans? and it was, it's always been a

mystery why such an intelligent person who's done a lot of good things, a strategic thinker, could believe such a thing. fortunately -- and that has cost about 300,000 lives according to a study from harvard because it delayed the introduction of antiretroviral therapy, of prevention of mother-to-child transmission in the country and maybe also in some neighboring countries although his colleagues maybe they were sometimes listening politely, but they didn't follow him, fortunately, in this. now today south africa has the largest hiv treatment program in the world, and things have changed really the day that he, you know, he was, actually, fired as president. but it's a tragedy. and it must be, um, yeah -- i don't know why, what it is. i really don't know. >> well, in a very different

mood you're with someone who over, oh, seems like two days of rum if i follow the description, but an ample quantity of alcohol is consumed to discuss mandatory quarantine of hiv-positive people in cuba, and this would be with fidel castro. >> right. congressman -- commandant as he's called. yes. i went to cuba for several reasons. one, there was compulsory warn tee. most of the cubans with hiv were former soldiers, the military who were fighting in africa and who came back with hiv and were locked up basically. and in a conversation with fidel castro, human rights is not something that is very discuss bl, so we talked about it as, basically, that it's not effective, um, that it doesn't work, um, and today what happens

in cuba is that when you're found to be hiv positive, you've got to follow a six months course as i don't know this was a few years ago, whether this is still the case, but to prepare you for life with hiv. the drugs are there. um, and then many people become hiv educators since everybody's a state employee, basically, it doesn't matter what you do. so you're reoriented. but it was, yeah, it was -- i came there, and first time i met fidel was in the middle of some kind of nato, so he was asking me about how many leaders -- the ambassador was there. how many liters per square meet e you know, he's a man of figures. and after i said, commandant, i came here to talk about aids. i express my solidarity with the

people affected by floods, ah, yes, he said. and then he started talking about how many cases in jamaica, how many there, how many there. and anyway, and sometimes he knew the figures better than i do because despite the fact i'd been a professor of epidemiology, i have a hard time remembering these figures. and then he said, okay, let's have a drink in my office. so we went in the office, and i asked him for water because i said i just arrived from europe jet lagged, and i said i need to make sure i do my best here, and then he said, no, no, no, you don't drink water. so what else? so mow here toe, okay. we are -- no here toe, we are in cuba. to make a long story short, we ended up, as he does sometimes, he called in half of the government and the vice president, we had dipper, and we talked -- we had dinner, and we talked a lot about lots of things including the eminent

decline of capitalism. >> oh, it'll be dead any second. [laughter] >> it was last century, it still hasn't happened. >> i'd like michelle to join us, and as he's coming up the stage, you end up deciding to go for the job creating unaids. it didn't even have a name then, but it's this new entity that's going to happen. and there are two african colleagues that offer you smart advice, kofi annan says beware the sea is full of sharks -- >> yes. [laughter] >> and he's not secretary general yet of the u.n. at that time. >> plus, he said -- hold on -- >> go ahead. >> also he said, also so don't fall into the water. and if you fall into the water, don't bleed. >> don't bleed. [laughter] >> so it's -- >> and then a certain michelle si dee bay who was unicef at the

time. michelle tells you the story of the chameleon. what was the chameleon? what was that advice? >> that was in kampala when we met in a chateau. >> [inaudible] >> yes. [laughter] yes. >> and what was the story? >> no, i think the story is a story from our childhood. generally when they are 13 years old, they ask them to observe a -- [inaudible] and after that they ask them what did they learn? in general, the smartest children will say changing color, but that's not important. the most important is, okay, the first thing is the chameleon is always walking without moving the head. so in life is very important to have an objective. objective set in the very clear manner. so that's first lesson.

second lesson is good to have an objective, but if you don't have a good understanding of the -- [inaudible] and you don't put that in perspective with your strength and your weaknesses, you will never move. that is the second lesson. the third one even if you have, you understood you have objective clear, you try to never make people always your target because they can miss you once, two but maybe one day they will not miss you. so is important to really give some time, space for people to give you what they know so you can learn more. so and that's third. fourth is that you have to be present in life. that is clear. >> go step by step. >> go step by step. and the fifth one is that even this chameleon, if he's just one second before his target, he

will never change the space. he will always have self-control. so in life very important for self-control. if you can do all of that -- if not, you can do all of that and miss your objective. and the last one is caption. >> this this is like the story of creating unaids. because what you describe is the entire u.n. system was against you. it's almost a miracle the organization came to exist. [laughter] and you describe episode after episode where either a major western donor or donor agency or a rival that should not have been a rival agency representative from within the u.n. system was, like, sabotaging what you were trying to do. >> yeah. certainly from a number of agencies. i would say that -- [inaudible] who was then executive director of finish.

[inaudible] you were an exception. you gave me a hard time at the interview, but -- >> you gave me a hard time -- [inaudible] [laughter] >> she said she crossed him off the list. [laughter] >> you see -- >> [inaudible] and he said, how could you not cross him off in. >> we need a microphone if we're going to -- [laughter] >> of that i didn't know. >> [inaudible] i said, okay. so they brought him in, and here comes -- [inaudible] and by this time, by this time i've read up on him. so then i'm certain that i had crossed him off, but i did interview him nevertheless. and, of course, the is history. >> with yeah. no, but it's true when you see -- it was at several levels, but particularly mid-level management there were people like at unicef, and they told me if you ever come, we'll do

everything we can to undermine you and make sure this doesn't happen. in who the director general basically thought that in one year time it would be, you know, it would be how to say, we will just kill it, etc. anay, it's kind of too ridiculous to even talk about. when i was writing about it, i said, oh, my god, how is this possible? but to go beyond personalities, there is indeed an issue of the -- in the u.n. system which is very rich in terms of its diversity and different agencies, and everybody is looking for money, fundraising. so, no, there is a lot of turf and all that going on. and i don't think that coordination is actually the solution in the work. but i must also say that probably it's in aids that we

are the most advanced, best integrated. there is nothing that comes close as far as i can see, so unless something happens -- >> so it's all one big happy family now? >> no, let me first say that what is very difficult is what peter was talking about. you have a conflicting interest sometime in that people have to fight for their agenda, they have to make sure that they are relevant. so it make all coordination sometimes very difficult. but what i am seeing now which is grudging me is that we manage to be a little bit beyond those individual agenda, to identify cross-cutting interests and identify key result areas which is making us certainly moving collect collectively together. seeing that, for example, is so important to save life for people. saving life for people means what? is to bring people at the center. if we bring people at the

center, we are not talking about unicef and others, we start looking on how we can create synergy to act together. i think that is helping us. but at the beginning it was not possible. it was not possible. peter was coming from who, and who was not understanding why this organization has been created, and each organization was fighting to create their own identity with hiv. so his job was very tough one. >> a turf battle. >> yeah. but what i've seen is that the u.n. system is that it's best when it coalesces around a very concrete outcome and deliverables. and then it can move mountains. if it just concentrates on process as is often the case particularly near new york, then it's hopeless and a waste of time for everybody. so that is, i think, my conclusion, and i don't know -- [inaudible] the executive director of unicef. your body language tells me that

you agree. [laughter] >> well, mi, which -- michel, today at this moment the g20 leaders are probably drinking tequila at loss cab bose, and they've probably had a day of accomplishing very little. and also at this moment in rio they're probably drinking rum at the rio plus 20, and there's very little optimism for that meeting. we're in a moment where everything seems to pivot on the euro crisis, the amount of money on the table keeps shrinking, the sense of general generositys shrinking and we've seen since 2008 with the financial crisis ever-greater dependency on one source: the united states government. >> yep. >> which is now, i think, about 60% of support for international hiv efforts. what, what does this mean for you in terms of trying to

coordinate a global response? >> you know, i think it's very important. pete err said something -- peter said something, he said that the world was changing, and i believe that one. ten years ago when we're talking about development goals, africa was nowhere. we are not talking about growth rate there at 6, 7%, even high as the growth rates like in ghana we have 15%, ethiopia, 11%. we're not talking about emerging nations, china, brazil and others as a key player in the new global government system. so for me what is important today is what we are planning to push is to bring the debate around shared responsibility. saying that we want to change, we cannot use the old paradigm which is obsolete development paradigm which we have been using until now. so what we are trying to push is having burden sharing, bringing

different players. we have been able to work with the chinese, and the chinese now are paying for their own aids response which is very important, less billion dollars which global fund pay. we have been working with india, india decided to pay for all their response from this year, so we are seeing south africa increasing to $1.5 billion. so we are seeing the world come in with response in different way. and we need to make sure that of course it will base on social justice, better redistribution of opportunities. that is critical because if not, we'll not be able to make it. i was in san francisco, i met someone there who i said to peter, it told me that is treatment cost is $72,000 per year per person. how that can happen in malley or -- [inaudible] -- mali or. [inaudible] if we know we have nine million people waiting for treatment in

africa, we need innovation. we need to develop change. so i think like a new movement coming which is very important. and that is built on what peter did. peter is -- i know peter very well. he was my boss and my mentor, he's one of the best scientists probably we have, and he has also this humility to share not all what he has been able to do for the world. because today if we save millions of lives, it's peter piot on hiv. e wallet to say that -- i want to say that. we're looking for results country by country where it's working, why it's not working. today we have almost seven million people on treatment. that is peter. peter move us from million to billion in terms of resource mobilization demonstrating that the solidarity from individual collectives, solidarity from american was indispensable to

save lives for people. and i want to say thanks to peter for that. and i'm building on that. >> thank you, that's nice, michel, but when you look at the index of this book, it's only people. and that's on purpose. and why? because, okay, i was maybe the front which had not only its pros, anything that was going wrong anywhere in the world in terms of aids was my personal -- [laughter] but what i wanted to show is that this is a movement, and there were so many people contributing and all equally important. but what's important be also is that making sure it's not a brown skin movement which sometimes it looks like going into all direction and try to align the stars, you know? where the politics and the science and programs on the ground are kind in harmony or supporting each other. and that is going to be very important. now, it's not normal that the

global fund for years funded programs in argentina, in mexico, in chile, in china and so on. and that was actually, basically, denying money to the countries that are in the greatest need. take zambia. according to our projections that we did, you know, by 2030 be, '31, 50 years after the beginning of the aids epidemic will require 4% or more of its gdp to treat people -- >> on treatment costs. >> just on treatment costs. ..

>> when the last time the aids community convened in washington, d.c., they publicly denounced a vice president george bh during the reagan presidency and angered him so much when he took over as president, he said i don't want to hear about the aids talk. get out of the room. what -- if there's one message that the american people take from this upcoming conference, and you could make it happen

opposed to other scenarios that may happen, what would that message be? >> just coming from listening to new york, washington, san fransisco, oakland, and i want just to say that it gives me the opportunities to say their individual and collective effort save the life of millions of people, and that is not to please them. it's to cross party effort. i said republican to democrat because we have a sense of urgency broughtly president bush. it's completely changing all of our response. we have obama brought by bringing debate, sharing

responsibility, looking on stainability, ownership or just natural movement which we need to share and dallas -- i hope this message will be able to convey because american people individually in their differences need to hear they are saving life of millions of people. we have to share the burden with other countries now, and that should be the message. >> peter? >> along the same lines. save money, save millions of lives, and has also, i think, improved american image in the world to a large extent. decreasing that effort now is not only going to cost millions of lives because people will die, but also, i think, would be stupid from a perspective of smart foreign policy.

now, let's see how our friends -- the biggest problem i have is the conference may be how do american aids activists going to handle that? that is, i think, the biggest challenge. >> well, that's a good note to take questions from the audience. i ask that you raise your hand, wait until the microphone reaches you, identify yourself, and give us a real question. there's one right here, down front. robert martin from the rockefeller foundation. >> okay. thank you. >> would you stand? >> sure. thank you for the book. i flew through it in a few days. feeter, i agree it will inspire the next generation, and following on the first question is what advice do you have for the next generation of global or public health leaders, and then the second question is at one

point in the book, i think it's towards the end when you leave unaids, you had like an oscar schindler moment where you think you could have done more or doing things differently. the question is if you could go back and redo the last 10 or 15 years, what would you do differently, if anything? >> the first advice, one is that the world is becoming really very global place so there is a great future in working in global health. don't plan your career in detail because you want it to be boring and you'll miss great opportunities. i think i certainly didn't imagine i would be a u.n. bureaucrat or discover a virus or whatever, but be prepared. this is my old boy scout time, you know, be prepared. invest in your training.

skills, all of that so you can seize these opportunities. there are many open doors that are there, but people don't go through them. even if you don't know what's behind them, take some risks. what would i have done differently? i think probably politicize aids faster. by that i mean when i started unaids, i was naive. i thought it was going to change everything. i should have knew this before, and, of course, that was not the case, and so we -- i should have brought it earlier to that kind of that drsh to the big political agenda, but maybe it was not possible. i think that's probably the biggest -- i don't know. i still wonder could i have accelerated things? it was also slow.

i -- on the one hand, i have no patience for things, and on the other hand, you know, you have to go through certain things. i really don't know. i wish i knew. >> right here, gary. stand up, please. >> i always tell people i am standing. [laughter] that was my life as a child. in my more recent travels in africa working with fantastic people from cdc and elsewhere fighting the battle, you get the sense as a turning point, i don't know if it's a tipping point, but the success, the aids free generation, use of ert viral sus presentation. there's signs of encouragement, in fact, that the end point, if you will, could be in sight making this is critical time to ensure momentum is not lost. do you agree with that

characterization? secondly, what could help drive momentum forward, and alternatively, what could risk it in? >> that is a very good point. for me, getting to zero is my vision, zero means nothing, but it is a vision for making society more inclusive. taking the decision to say we don't discriminate people based on their race or based on their sexual orientation or based on their social status, it is our decision. we can get it. i am seeing process every single place. when i decide to push for zero new infections amongst babies, i think by 2015, and supporting me

strongly, by 20 # 15, we don't need to have baby born with hiv. from where we get that, and today, i will share the number with you, from last year to this year, increased by 100,000, the numbers of babies with hiv compared to last year. we are also seeing increased numbers of people in this crisis on treatment. we are seeing a new momentum that if we put people early on treatment, we can reduce the new number of new infections. for me, i'm seeing hope there. i want to push for the ideas of getting to zero. by doing that, multiple, we can

be there if we walk together. for me, it's time to bring this can-do approach because it would be a missedded opportunity if we don't do that. >> yeah, i agree with the vision we cannot accept anything less in a sense, but we have to be prepared for decades of investment and continue it. starting with people who are now on antiviral retro therapy. we hope that lasts and will be effective for decades for normal life expectancy. we have to be prepared for thatment i think we're not prepared for it. >> we're seeing a rising tide of drug resistance already. >> drug resistance. the pipeline of new drugs is drying up, and generic manufacturers pulling out because the prices become so low that, you know, they don't make profit, and they are moving to

drugs for diabetes and cardiovascular disease. i think we need to have that ambitious vision, but also we need to -- yeah, we have to be prepared for this longer term, but i agree there is a momentum there where we see a return of the investments over the past decade because these things do not happen overnight. i agree with peter. we need to be able to have perspective of the long term. we have to change compleelg -- completely our way of dealing with innovation. we not be able to scale up so quickly. it's impossible for me to believe that you will go to 15 million to 20 million people in

africa if you have machines everywhere, and if you need to know so the simplification. sending a letter to the partner, a yellow pill and red pill which will simplify it, one pill a day, and looking how we bring our life is something to do now. bring groups together to see how we work together to simplify. if we don't simplify, not possible. today, let me give you one example. just to make sure that we are, the 9 million people waiting for treatment, that cost $700 million. not working in a difficult environment, so i was in institutes in australia in mel bourn, and they are testing a

tool today. with one dollar, they take the blood. three minutes later they can tell you if it is 350 or below 350. for me, i am looking for innovation because to shift the task, work to be done by educated people, and the important interface between service provider and community and increase the demand. if we don't have a shift in innovation, no way. >> i agree with that. >> i should clarify for the audience that cd4 cells are a type of cell in the human immune system that are very specifically targeted by the hiv virus. as your cd4 count, you're clearly heading towards a far sicker stage of the disease. i think we have time for at least one more question. i think i saw ann star of family

care international back there. >> thank you. i wanted to ask if you can comment specifically on what you see as the priorities and the trends and possibilities in sub is saharin africa, and looking from the perspective of the long term potential and the question of what is the most strategic approach in terms of dealing with hiv/aids as more or less a vertical issue or integrating it with the provision of basic health services, reproductive, newborn, child health department services, looking at mcds coming down. what's the most productive strategy of dealing with this in africa? >> i think i build on what peter did when we were working together, when peter